ObjectiveTo evaluate the methodological quality and reporting quality of published guidelines/consensuses on traditional Chinese medicine （TCM）/integrated traditional Chinese and Western medicine diagnosis and treatment of nonalcoholic fatty liver disease （NAFLD）， and to provide a basis for formulating guidelines/consensuses on TCM/integrated traditional Chinese and Western medicine diagnosis and treatment of NAFLD in the future. MethodsDatabases including PubMed， Embase， Web of Science， CNKI， Wanfang Data， and CBM and the websites of China Association of Chinese Medicine and China Association of Integrative Medicine were searched for related articles published up to September 1， 2024. Two clinical researchers independently assessed the methodological quality and reporting quality of the guidelines/consensuses on TCM/integrated traditional Chinese and Western medicine diagnosis and treatment of NAFLD by using Appraisal of Guidelines for Research and Evaluation Ⅱ （AGREE Ⅱ） and Reporting Items for Practice Guidelines in Healthcare （RIGHT）. ResultsA total of nine guidelines/consensuses were included after literature screening， with four guidelines and five expert consensuses. The scores of different domains assessed by AGREE Ⅱ for the nine guidelines/consensuses were as follows： scope and purpose （47.1%）， stakeholder involvement （41.0%）， rigor of development （21.6%）， clarity of presentation （40.2%）， applicability （19.0%）， and editorial independence （19.6%）. The recommendation level of the articles was B level （recommended after revision） for four articles and C level （not recommended） for five articles. The RIGHT assessment showed high reporting rates for “Basic Information” and “Background”， while other areas needed to be improved. Currently， there was no international standard for the guidelines/consensuses on TCM/integrated traditional Chinese and Western medicine diagnosis and treatment of NAFLD， and the quality of these guidelines/consensuses needed to be enhanced to ensure comprehensiveness and credibility. ConclusionThere is still potential for improving the quality of guidelines/consensuses on TCM/integrated traditional Chinese and Western medicine diagnosis and treatment of NAFLD， and AGREE Ⅱ and RIGHT checklists should be strictly followed to ensure the fairness， scientific rigor， and transparency of these guidelines/consensuses.

Objective To investigate the association of sleep disorders with the development and progression of nonalcoholic fatty liver disease(NAFLD).Methods A total of 1 868 participants from the health examination cohort and fatty liver cohort of Beijing Friendship Hospital from June 2022 to June 2023 were enrolled as subjects.Related data were collected from all subjects,including age,sex,education level,chronic medical history,and biochemical parameters,and all subjects completed Pittsburgh Sleep Quality Index(PSQI)scale independently.According to the diagnostic criteria,the subjects were divided into non-NAFLD group with 1 122 subjects and NAFLD group with 746 subjects,and according to the stage of progression,the patients in the NAFLD group were further divided into simple fatty liver group(SFL group with 624 subjects)and nonalcoholic steatohepatitis(NASH)group with 122 subjects.A one-way analysis of variance or the Kruskal-Wallis H test was used for comparison of continuous data between three groups.The chi-square test was used for comparison of categorical data between the three groups.The binary Logistic regression analysis was used to investigate the association between sleep factors and NAFLD,and the multinomial Logistic regression analysis was used to investigate the association between sleep factors and the different stages of NAFLD;two multivariate models were constructed for adjustment of potential confounding factors,i.e.,an age-sex adjustment model and a multivariate adjustment model,and the multivariate adjustment model adjusted the factors of age,sex,education level,smoking,diabetes,hypertension,body mass index(BMI),triglyceride(TG),and high-density lipoprotein cholesterol(HDL-C).Results There were significant differences in age,sex,BMI,education level,smoking,diabetes,hypertension,alanine aminotransferase,TG,and HDL-C between the non-NAFLD,SFL,and NASH groups(all P<0.05).There were also significant differences between the three groups in the total score of PSQI scale and the proportion of subjects with a score of 0—3 points for the 7 sleep components(all P<0.05).The multivariate adjustment model showed no significant association between sleep disorders and SFL,while long sleep latency(odds ratio[OR]=4.04,95%confidence interval[CI]:2.33—7.03,P<0.001),short sleep duration(OR=3.53,95%CI:1.83—6.82,P<0.001),and severe sleep disorders(OR=2.96,95%CI:1.48—5.93,P=0.002)were closely associated with the risk of NASH.Conclusion Overall sleep condition and its components of sleep disorders are not significantly associated with the simple fatty liver;however,long sleep latency,short sleep duration,and severe sleep disorders can increase the risk of NASH,which should be taken seriously in clinical practice.

Objective To evaluate the effects of puerarin on bone density in rats and mice through a meta-analysis. Methods The databases, including CNKI, SinoMed, Wanfang data, VIP, PubMed, EMBase, Web of Science, the Cochrane Library, and Scopus from their inception to November 6, 2023, were searched for literature on the effects of puerarin treatment on bone density in rats and mice. Inclusion criteria for the literature were randomized controlled trials with a placebo or blank control group; the subject animals were rats or mice; the intervention was puerarin; and the results included bone density measurements. Exclusion criteria included combination therapy with puerarin; lack of original research data; unpublished studies; and using mandible as the measurement site for bone density. Risks of bias were assessed using SYRCLE's RoB tool. Data analysis was conducted with Stata 16.0 and Rev Man 5.3 software. Results After applying the inclusion and exclusion criteria, a total of 429 records were identified and 42 articles covering 41 studies were ultimately included. 925 animals were involved and the data analysis results indicated that puerarin improved bone density in rats and mice compared to the control group: femur [37 studies, n=824, standardized mean difference （SMD)=2.12, 95% confidence interval (CI)=1.69-2.54, P < 0.000 1], lumbar spine (13 studies, n=271, SMD=2.25, 95% CI=1.49-3.01, P < 0.000 1), tibia (4 studies, n=95, SMD=0.94, 95% CI=0.05-1.83, P=0.04), and the whole body (4 studies, n=94, SMD=1.89, 95% CI=0.50-3.29, P=0.008), with all inter-group differences in bone density being statistically significant. Conclusion Puerarin can improve bone density in rats and mice. This study provides a valuable reference for clinical studies on the prevention and treatment of osteoporosis with puerarin.

Objective To summarize the common traditional Chinese medicine(TCM)syndrome types and syndrome characteristics of depressive disorder(DD)by analyzing the existing clinical research literature,and to provide a basis for TCM syndrome classification and research on DD.Methods The documents related to TCM syndrome classification of DD were retrieved systematically from China National Knowledge Infrastructure(CNKI),China Biology Medicine Literature Service System(SinoMed),China Science and Technology Journal Database(VIP)and China Academic Journals Full-text Database(WanFang).The literature was organized and analyzed,and Gephi software was used to do the visual analysis.Results A total of 262 literature that met the criteria were included in the study.The annual average number of publications exceeds 10 articles since 2010.The top 5 syndrome types in TCM were Liver Qi Stagnation(LQS)type,Liver Stagnation and Spleen Deficiency(LSSD)type,Heart and Spleen Deficiency(HSD)type,Liver Stagnation and Phlegm Obstruction type and Liver Stagnation and Kidney Deficiency type,viscera syndrome classification mainly involved Liver,Spleen,Heart,Kidney and Gallbladder.The main syndrome type based on deficiency-excess syndrome classification was excess type.The strongest correlation of excess type was LQS,the strongest correlation of deficiency types was HSD,and the strongest correlation of deficiency and excess mixed syndrome type was LSSD.Conclusion The publication volume of literature related to TCM syndrome types of DD shows a fluctuating upward trend.The occurrence and development of DD are related to dysfunction of multiple organs,and liver stagnation is the core syndrome,which may run through the entire process of DD.

Presynaptic dopaminergic PET imaging is a useful method for the diagnosis of parkinsonism. Based on the expert consensus on operation and clinical application of dopamine transporter brain PET imaging technology published in 2020, this paper further recommends the relevant elements of result interpretation of presynaptic dopaminergic PET imaging.

Photothermal therapy has the characteristics of minimal invasiveness, controllability, high efficiency, and strong specificity, which can effectively make up for the toxic side effects and tumor resistance caused by traditional drug treatment. However, due to the limited tissue penetration of infrared light, it is difficult to promote and apply in clinical practice. The eye is the only transparent tissue in human, and infrared light can easily penetrate the eye tissue, so it is expected that photothermal therapy can be used to treat fundus diseases. Here in, a new nano-platform assembled by liposome and indocyanine green (ICG) was used to treat retinoblastoma. ICG was assembled in liposomes to overcome some problems of ICG itself. For example, ICG is easily quenched, self-aggregating and instability. Moreover, liposomes can prevent free ICG from being cleared through the systemic circulation. The construction of the nano-platform not only ensured the stability of ICG in vivo, but also realized imaging-guide photothermal therapy, which created a new strategy for the treatment of retinoblastoma.

Genome miniaturization drives key evolutionary innovations of adaptive traits in verte-brates,such as the flight evolution of birds.However,whether similar evolutionary processes exist in invertebrates remains poorly understood.Derived from the second-largest animal phylum,scallops are a special group of bivalve molluscs and acquire the evolutionary novelty of the swimming lifestyle,providing excellent models for investigating the coordinated genome and lifestyle evolution.Here,we show for the first time that genome sizes of scallops exhibit a generally negative correlation with loco-motion activity.To elucidate the co-evolution of genome size and swimming lifestyle,we focus on the Asian moon scallop(Amusium pleuronectes)that possesses the smallest known scallop genome while being among scallops with the highest swimming activity.Whole-genome sequencing of A.pleuronectes reveals highly conserved chromosomal macrosynteny and microsynteny,suggestive of a highly con-tracted but not degenerated genome.Genome reduction of A.pleuronectes is facilitated by significant inactivation of transposable elements,leading to reduced gene length,elevated expression of genes involved in energy-producing pathways,and decreased copy numbers and expression levels of biomineralization-related genes.Similar evolutionary changes of relevant pathways are also observed for bird genome reduction with flight evolution.The striking mimicry of genome miniaturization underlying the evolution of bird flight and scallop swimming unveils the potentially common,pivotal role of genome size fluctuation in the evolution of novel lifestyles in the animal kingdom.

Objective:To validate the feasibility of a deep learning-based clinical target volume (CTV) auto-segmentation algorithm for cervical cancer in clinical settings.Methods:CT data sets from 535 cervical cancer patients were collected. CTVs were delineated according to RTOG and JCOG guidelines, reviewed by experts, and then used as reference contours for training (definitive 177, post-operative 302) and test (definitive 23, post-operative 33). Four definitive and 6 post-operative cases were randomly selected from the testing cohort to be manually delineated by junior, intermediate, senior doctors, respectively. Dice coefficient (DSC), mean surface distance (MSD) and Hausdorff distance (HD) were used for test and comparison between auto-segmentation and RO delineation. Meantime, auto-segmentation time and manual delineation time were recorded.Results:Auto-segmentation models of dCTV 1, dCTV 2 and pCTV 1 were trained with VB-Net and showed good agreement with reference contours in the testing cohorts (DSC, 0.88, 0.70, 0.86 mm; MSD, 1.32, 2.42, 1.15 mm; HD, 21.6, 22.4, 20.8 mm). For dCTV 1, the difference between auto-segmentation and all three groups of doctors was not significant ( P>0.05). For dCTV 2 and pCTV 1, auto-segmentation was better than the junior and intermediate doctors (both P<0.05). Auto-segmentation time consumption was considerably shorter than that of manual delineation. Conclusions:Deep learning-based CTV auto-segmentation algorithm for cervical cancer achieves comparable accuracy to manual delineation of senior doctors. Clinical application of the algorithm can contribute to shortening doctors′ manual delineation time and improving clinical efficiency. Furthermore, it may serve as a guide for junior doctors to improve the consistency and accuracy of cervical cancer CTV delineation in clinical practice.

Objective To assess the changes of white matter microstructure in neuromyelitis optica spectrum disorders (NMOSD) with DTI based on tract-based spatial statistics (TBSS) method.Methods Conventional MR and DTI were performed in 20 NMOSD patients (NMOSD group) and 20 healthy volunteers (control group).DTI data were analyzed with TBSS procedure,which was a part of FSL software packages,and non-parametric statistical analysis was performed on the whole brain.Correlation between FA value of tracts with significant difference in NMOSD group and expanded disability status scale (EDSS) scores was analyzed.Results TBSS analysis revealed significantly (P＜ 0.05,FWE corrected) extensive decrease of FA value in cerebrum and cerebellum white matter fiber bundles,i.e.corpus callosum,fornix,corticospinal tract,unciform fasciculus,cerebellar peduncles etc.in NMOSD group,and decrease of AD value,increase of RD value in cingulum bundle,corpus callosum and fornix,while MD value only increased in fornix and retrolenticular part of the left internal capsule (P＜0.05,FWE corrected).Negative correlations were found between FA value of left uncinate fasciculus,right external capsule,left inferior cerebellar peduncle,bilateral anterior limb of internal capsule,medial lemniscus and EDSS scores (all P＜0.05).Conclusion Widespread white matter damage is observed in cerebrum and cerebellum in NMOSD patients by using TBSS analysis,which may partly correspond to the disabilities of NMOSD patients.However,the other microstructural changes of white matter tracts may suggest complicated pathological mechanism of NMOSD.

Objective To assess the damage of limbic system pathways in relapsing-remitting multiple sclerosis (RRMS) by diffusion tensor imaging (DTI) tractography.Methods DTI tractography was used to acquire fiber numbers,fractional anisotropy (FA),mean diffusivity (MD) of cingulum,fornix,and uncinate fasciculus (UF) in 20 RRMS patients (MS group) and 20 healthy volunteers (control group),and statistical analysis was performed.Results Compared with control group,lower FA value (P＜0.01) and higher MD value (P＜0.05) were found in cingulum,fornix and UF of MS group,and the fiber numbers of fornix decreased in MS group (P＜0.001).There were significant differences between the left and the right UF in fiber numbers and FA value of control group and the fiber numbers of MS group.Negative correlations were found between FA value of cingulum and UF and EDSS scores in MS group (r=-0.572,-0.665,both P＜0.05),and positive correlations were found between MD value and EDSS scores (r=0.627,0.603,both P＜0.05).Conclusion DTI tractography is valuable in assessing MS associated limbic system damage and in monitoring the clinical progression of the disease.